Ankle Bracing: Ankle Brace Or Taping Which Is Better?

Ankle Bracing: An Effective Method For Preventing Ankle Sprains

Ankle sprains typically occur as a result of a twisting movement from a miss timed step, awkward landing, or being on the receiving end of an ill-timed or aggressive tackle during sport. Such injury mechanism can potentially cause damage to several soft tissues around the ankle and sometimes this soft tissue injury is associated with concurrent bone and/or cartilage damage. Easily the most common type of ankle sprain injury we see in our Randwick and Sydney physio practices is an injury to the lateral ligaments of the ankle. Lateral ligament sprains of the ankle are a type of ankle sprain where there is a stretching or tearing of the outside (lateral) ankle ligaments and typically occurs when the ankle is in a slightly pointed position and then the foot is twisted inwards in the direction of moving towards the other foot. The biggest risk factor for an ankle sprain is previous ankle sprains, meaning if you have previously injured your ankle then the likelihood of suffering subsequent injury at a later date is increased. Beyond the acute management of an ankle sprain a large chunk of a physiotherapists approach when rehabilitating ankle sprains is working towards restoring the individuals balance control to prevent re-injury. However, frequently individual training/sport demands require a return to activity sooner than full recovery is achieved, meaning prophylaxis approaches such as the use of ankle bracing, or strapping can assist in enabling an early and safe return to play.

How Wearing An Ankle Brace Works

Wearing a brace can help to support the ankle and provide protection against twisting type injuries and ankle bracing has been shown to be an effective method in the prevention of ankle sprains. The injury mechanism of the common ankle sprain frequently comes as the result of a twisting situation where the muscles supporting the ankle are not prepared for the injury causing motion and either react to slowly or do not react strong enough to prevent the twisting. Some of the common situations that may lead to an ankle sprain include:

• being knocked when landing from a jump, or landing on an uneven surface following a jump, step, or changing direction (this also includes landing/stepping on someone else’s foot).
• being knocked or bumped immediately prior to the planting of your foot when looking to land from a jump or cutting action are other common causes.

A brace in these situations can work to protect the ankle where the muscles have neither the time or strength to react in slowing or preventing the twisting movement. Following an ankle sprain it is common the injured ankle ligaments heal with decreased ability to maintain ankle stability and the ankle has what is referred to as laxity. This can occur if there is a complete rupture of the ankle ligaments, or if the healing process sees the ligaments “stretch out” a little as they repair. In situations where there is less structural support from the body’s tissues taping, or ankle bracing when necessary, can work as a temporary “substitute” for this lack of structure ligamentous stability.

Ankle Bracing: Early Prevention And Protection Following Acute Injury

The use of ankle braces is often used in physiotherapy when looking to immobilize and prevent further injury early on following an acute sprain. In moderate to severe graded injuries the use of ankle braces may be recommended to protect the healing ligaments so not to allow them to be reinjured or lengthen during the healing process and this is common practice for our physio team to consider in our Randwick and Sydney physio practice locations.

Who Is Likely To Benefit From The Use Of Ankle Supports?

Using some form of ankle support is appropriate for athletes who have sustained a previous twisting ankle injury and are returning to high-risk activities such as contact sports or sports involving jumping and landing, cutting, and changing direction or sports played on uneven surfaces. It should be mentioned here that the use of an ankle brace should not be considered a substitute for appropriate rehabilitation but simply as a component of the entire rehabilitation process. Ultimately the best results following twisting your ankle combine a comprehensive rehabilitation program focusing on the restoration of full range of movement, strength and balance control, coupled with timely ankle taping, or bracing. Such an approach will give an athlete the best chance of returning to play sooner and assist in avoiding re-injury.

Will Any Old Ankle Brace Suffice?

Ankle bracing does not need to cost a fortune, I find that basic braces referred to as a combination brace are the braces I most commonly recommend. These combination braces have a lace up feature down the front with over lapping stirrups and are typically cheap and cheerful and in my experience.  A brace that is highly effective at preventing both excessive lateral and rotational movements of the ankle. There are several known brands out there (mcdavid ankle brace, donjoy stabilizing speed pro ankle brace…) making these types of braces and frequently they will only set you back somewhere around $60 which in my opinion make them well worth the investment. Personally, I am yet to see someone re-injure their ankle when wearing an appropriate fitted combination brace, I’m not saying it is impossible to hurt your ankle wearing this type of ankle support as sadly it doesn’t make you “bullet proof” but they certainly go a long way towards protecting your ankle from reinjury. Sports such as basketball, soccer and the rugby codes where cutting and twisting movements are frequently involved, I will commonly advise patients to consider the use of a combination brace like mentioned above.

How Long Should Ankle Bracing Continue For Following Injury?

I typically advise most of my patients who suffer a significant ankle sprain injury that they brace or tape their injured ankle for around 6 months (often up to a year following injury). If it is a minor sprain and the ankle maintains its ligamentous stability and the athlete has restored their dynamic balance control then there may be no need for long-term bracing or taping, and they can begin to wean off the use of bracing prior to this point. But if the brace is not impacting performance, then use during high-risk activities for an extended period can frequently make a lot of sense.

Are Ankle Supports Necessary For Training, Or Just On Game Day?

Any time you participate in high-risk activities such as exercising on uneven surfaces, contact sports or sports involving jumping, cutting, and changing direction the use of bracing, or taping to stabilize following injury is advised. Exposure to injury risk in these above situations regardless of if it is “just a training session” is still high. Therefore, if the use of some form of ankle support is deemed necessary for match day, it is also necessary when training.

Ankle Bracing Verses Taping, Which Is Better?

This decision comes down to a few factors, research comparing ankle bracing and taping show that they have nearly the same level of effectiveness.

• So, one of the things to consider around deciding between an ankle support and taping is $$$. Typically taping in the long run is going to work out more expensive, taping is not a one off purchase like a brace, so money wise taping one or both of your ankles for training and game days over an extended period it is going to add up!
• Taping is generally more time consuming than slipping on a brace, lacing it up and wrapping around the stirrups.
• The effectiveness of ankle strapping relies not only on the amount of tape used but falls heavily on the skill of the individual applying the tape, the exact technique used for the specific injury and the position that the ankle is initially placed in for taping.

Seems like a pretty open and shut case in support of using bracing over taping. However, in certain sports the use of bracing can negatively impact performance. Braces are clearly more cumbersome than ankle taping and in a sport such as soccer a brace can affect the athlete’s playing ability. A brace can impact the “feel” of kicking the ball and affect the player’s “touch”. As well as this in situations where footwear is required to be particularly sung and additional room may not exist in the sports wear for the extra thickness of a brace then I would suggest taping may be a better option over a bulkier ankle brace. In these situations, to save a few dollars I find many of my patients opt for the use of an ankle brace on training days where a “good touch” isn’t as crucial and then when game day comes around and performance is key, they use taping for a better shoe fit and better feel on the ball. Obviously if you are unsure if the use of some sort of ankle support is relevant for you and if so what the best option is given your specific circumstances, then approach your physiotherapist and ask their opinion. Any sports physiotherapist will be able to point you in the right direction. Disclaimer: This information is provided as an educational service and is not intended to serve as a substitute for personalized medical advice. Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned in this post. Anyone seeking specific advice, or assistance regarding “ankle bracing” should consult his, or her physiotherapist, orthopaedic surgeon, general practitioner, sports medicine specialist, or otherwise appropriately skilled medical practitioner.